Asthma Documentation- Answer Key

Priority DTP: patient cant afford fluticasone and requires a lower cost alternative
Options:
- lower the dose of fluticasone to 125mcg inhaled BID (needed to say something
about most of the benefit in terms of asthma outcomes from low dose, still
considered a therapeutic dose)
- switch to an alternate ICS that is less expensive
Other issues to address:
-

Advise patient to follow up with MD in about a week (post exacerbation)

o Consider repeating PFTs after 2-3 months of controller therapy
o Consider development of an asthma action plan with the patient
Administer/ recommend influenza vaccination (and pneumococcal
vaccination)
Review inhaler technique
Pharmacist to follow up on asthma symptoms/ side effects in a reasonable
time frame

Other things to keep in mind:

-

You are writing the letter to the patients family physician therefore they will
already know much of the patients background information
o Several students wrote comments like patient last saw family doctor 6
months ago [this is not the right context given that you are writing
to that same family doctor]
In your plan be clear about who is taking responsibility for what (ex. I
reviewed proper inhaler technique with the patient vs review proper inhaler
technique with the patient)
Be careful that the wording of your recommendations do not come across as
telling the physician what to do